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Compliance

PPACA

The Healthy Dollars team have all been trained on the Health Care Reform Acts, both nationally and in the State of Vermont. All employees are insurance licensed, allowing us to provide an additional level of support to our brokers and clients with regards to the rules and regulations surrounding the Health Care changes and how they affect our plans.

Health Care Reform Overview-ACA

The Patient Protection and Affordable Care Act (PPACA), commonly called the Affordable Care Act (ACA) was signed into law in March of 2010. The goal of enacting the ACA was to increase the quality and affordability of healthcare insurance, as well as lowering the uninsured rate across the board of both public and private insurance. Under the ACA, numerous provisions were established such as, guaranteed issue, individual mandates, expansion of Medicaid, subsidies, and creation of health insurance exchanges to name a few.

Health Care Reform Overview-Act 48 (Vermont)

In May of 2011, Act 48 passed Vermont legislature. The goal of Act 48 was to create a healthcare exchange that will build the framework to eventually put Vermont on the path to a single payer system (Green Mountain Care) slated to begin in 2017. This law requires the State to take several steps to ensure that the single payer system will not cost more than the healthcare inflation of the past. The implementation of a Board, called the Green Mountain Care Board was created to oversee the mechanics in controlling healthcare costs and responsible for the creation of the healthcare exchange (Vermont Health Connect). In addition, the Green Mountain Care Board is tasked with providing a detailed plan for the eventual single payer system including budgeting and receiving a federal waiver currently slated to be available in 2017.

How This Impacts Individuals and Employers

Beginning in January of 2013, individuals are required to obtain health insurance through Vermont Health Connect (VHC) or pay a penalty at the end of the tax year. The PPAC mandate to have health insurance comes with eligible cost-sharing subsidies based on a sliding scale of household income. Small Employers ( defined as less than 50 employees) have to decide whether they continue to offer health insurance now through VHC, or de-couple health insurance from employment and let employees enter as an individual and potentially receive cost-sharing subsidies to help pay for monthly premiums. If businesses with 100 employees or fewer decide to offer health insurance, they will be required to use VHC in 2016. In 2017 all businesses will be required to use VHC as the method of providing health insurance. Qualified Health plans were developed based on “metal levels-platinum, gold, silver and bronze. All plans are must have essential health benefits and cover the same expenses across the board. However, the cost-sharing (premium vs. out of pocket amounts) will vary depending on the metal level chosen. The future of healthcare is constantly evolving. Our Team has a good understanding of the up-to-date information, and here to help. For more information on healthcare reform details please visit: http://hcr.vermont.gov/sites/hcr/files/Act48slides%20%5BRead-Only%5D%20%5BCompatibility%20Mode%5D.pdf